Individual
TERRA LYNN KLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6451 COME ABOUT WAY, AWENDAW, SC 29429-6022
(608) 217-5503
Mailing address
6451 COME ABOUT WAY, AWENDAW, SC 29429-6022
(608) 217-5503
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
19776
SC
367500000X
Certified Registered Nurse Anesthetist
215418
SC
Other
Enumeration date
08/07/2015
Last updated
12/03/2018
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